Spectrum of HRCT Scan Chest Findings in COVID-19 Patients as Categorized by Modified CO-RADS Classification

Sumera Tabassum,Shahbaz Haider,Shaista Shaukat

doi:10.12669/pjms.38.4.4687

Abstract

Objectives:The Dutch Radiological Society developed CO-RADS classification, a system for the classification of CT scan chest findings among suspected COVID-19 patients. However due to some important issues it was modified by authors and then applied on our study population. The objective was to study the spectrum of lungs involvement as concluded by HRCT scan chest finding and classifying it using the “Modified CO-RADS classification”Methods:This cross-sectional study was conducted jointly by the departments of Medicine and Radiology, JPMC from January 16, 2021 to April 30, 2021. This study includes suspected cases of COVID-19 patients aged between 18-80 years who came for HRCT chest. Their data variables were recorded. HRCT findings were classified using “Modified CO-RADS classification”. Patients’ results of real time PCR for COVID-19 were also followed.Results:A total of 78 patients presented to the study department during this study period. Of them 85.8% were male (n=67) and 14.2% were female (n=11). Out of the 78 patients, 58 were tested positive for COVID-19 on first RT-PCR on follow up. Among positive two patients (3.4%) had CO-RADS-1, 4 patients (7%) had CO-RADS-2, 19 patients (32.75%) had CO-RADS-3, 21 patients (36.2%) had CO-RADS-4 while 12 patients (20.7%) had CO-RADS-5 category. (CO-RAD-6 category was omitted). Of the patient who had negative results on RT-PCR, five patients had CO-RADS-4 while three patients had CO-RADS-5. On repeat RT-PCR all (8/8) patients of category IV and V proved Covid-19 positive.Conclusion:HRCT scan chest can be used for quicker diagnosis of COVID-19 patients in patients with respiratory complaints in whom prompt diagnosis is required and when RT-PCR investigation process would be taking prolonged time due to over burden during pandemic situation. “CO-RADS classification after modification” proved more effective communicative tool to label and understand the severity of lung involvement in Covid-19 disease.

Highlights

Coronavirus is a virus of the family of viruses named orthocoronavirinae which led to a pandemic commencing by the end of 2019 and named COVID-19
The single real time PCR test used for COVID-19 may not be positive in all real Covid-19 patients as may be explainable from its given sensitivity of 42 to 83%, being convenient and performable, it has been mainstay in diagnosis and management
Fifty eight patients were either positive for COVID-19 on RT-PCR at the time of HRCT or awaited result came positive on follow up

Summary

Introduction

Coronavirus is a virus of the family of viruses named orthocoronavirinae which led to a pandemic commencing by the end of 2019 and named COVID-19. This pandemic started in the city of Wuhan, China and later involved all parts of the world. The diagnostic test available for the diagnosis of COVID-19 virus is RT-PCR (Real Time Polymerase chain reaction ) with a sensitivity of 42% to 83%. The single real time PCR test used for COVID-19 may not be positive in all real Covid-19 patients as may be explainable from its given sensitivity of 42 to 83%, being convenient and performable, it has been mainstay in diagnosis and management. In pandemic when test was widely needed for all level of suspected patients having fever, mild to severe respiratory symptoms to follow up test in positive cases, its kits supply has been facing shortages from time to time

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